Organization
BALLARD SENIOR HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SHUMWAY BALLARD (OWNER)
(928) 243-3094
Entity
Organization
Contact information
Practice address
91 S MAIN ST, SNOWFLAKE, AZ 85937-5285
(928) 243-3094
(928) 563-0065
Mailing address
PO BOX 1347, SNOWFLAKE, AZ 85937-1347
(928) 243-3094
(928) 563-0065
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
444751
—
AZ
Enumeration date
12/18/2019
Last updated
12/18/2019
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